Healthcare Provider Details

I. General information

NPI: 1619266905
Provider Name (Legal Business Name): TEXAS HEALTH CARE, P.L.L.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/07/2011
Last Update Date: 09/30/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5801 OAKBEND TRAIL, SUITE 260
FORT WORTH TX
76132-3923
US

IV. Provider business mailing address

PO BOX 961205
FORT WORTH TX
76161-1205
US

V. Phone/Fax

Practice location:
  • Phone: 817-346-6000
  • Fax: 817-346-6009
Mailing address:
  • Phone: 817-740-8400
  • Fax: 817-378-3699

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number
License Number State

VIII. Authorized Official

Name: LARRY D. TATUM
Title or Position: C.E.O.
Credential: M.D.
Phone: 817-740-8400